Assessing and Treating Patients with Pain

Assessing and Treating Patients with Pain


Complex regional pain disorder also called reflex sympathetic dystrophy refers to a long-lasting pain illness which affects mostly one limb (leg, arm, hand, or foot) usually following an injury. Studies reveal that the disorder is as a result of damage to or breakdown of the peripheral and central nervous systems (Lohnberg & Altmaier, 2013). The ailment is characterized by prolonged or excessive pain and alterations in skin color, body temperature, and inflammation in the affected area (Marinus, Moseley, & Birklein et al., 2011). This particular case study is an assessment and treatment of a 43-year old white male who has been diagnosed with complex regional pain disorder. Three decision points are being explored to explain the reason for selecting the decision, expected results, and how the actual results differ from the expected results.

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Decision Point One
Selected Decision
Amitriptyline 25 mg po QHS and titrate upwards weekly by 25 mg to a max dose of 200 mg per day.
Reason for Selection
The patient is has chronic neuropathic pain as a result of nerve damage. Amitriptyline is a good prescription for patients who suffer pain as a result of damages in the nerves. The drug is also a tricyclic antidepressant and can serve to enhance mood and feelings of well-being, get rid of anxiety and tension, abate insomnia, and boost one’s level of energy. This particular patient reports that the family doctor also suggested he had depression. The progressive increment in the dosage of the drug is to ensure that the patient adapts to the effect of the drug progressively and hence eliminating the potential side effects (Schwartzman, Erwin & Alexander, 2009). Other medications are available for this ailment. However, their side effects are far beyond the ones a patient taking amitriptyline experienced.
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Antipsychotic is a psychiatric drug that is availed through prescription and licensing to treat different mental health illness, such as schizophrenia or bipolar disorder (Seeman, 2015). Other antipsychotics also treat extreme anxiety, physical problems like nausea, agitation as well as dementia. The antipsychotic prescription occurs in many different ways. Usually, it is taken orally in form of tablet or liquid and at other times, as depot injections. It is difficult to tell how an individual will respond to a given kind of prescription. This paper will argue using three decisions on how to prescribe medication to this case study ‘Puerto Rican woman with Comorbid addiction’.

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Decision #1
Selected Decision
Prescribe Antabuse (Disulfiram) dosage of 250mg orally every morning.
Reason for Selection
Mrs. Perez was diagnosed with alcohol use disorder and of the many ways to treat this disorder; use of Cvek (2011)’s Antabuse (disulfiram) as the best approach. She had chronic alcoholism and Antabuse is appropriate for such a person. Disulfiram blocks that enzyme which metabolizes alcohol intake and generates negative side effects when mixed with alcohol in the body. As a result, the medication will tend to keep the individual from drinking alcohol. Some of the side effects of Antabuse include metallic taste in the mouth, redness, chest pains, fast pounding heartbeats, spinning sensation.
Expected Results
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Alzheimer’s Therapy

Alzheimer’s Therapy

Assessing and Treating Individuals with Alzheimer Disorders
Alzheimer disorder is a continuous neurodegenerative disorder with a high statistical growth in the modern world. Research shows that the number of individuals with Alzheimer’s Disorder dementia is estimated to triple by the year 2050. The rise in Alzheimer’s Disorder prevalence has heightened the importance of more research on Alzheimer’s Disorder treatment. Past information and data have revealed that ancient medicine can be a source of motivation and inspiration to acquire new therapies (Maruish, 2012).

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There is a type of dementia in ancient Iranian medicine with similar signs and symptoms of Alzheimer’s Disorder. Iranian ancient medicine explains the causes of disorders by recognized Greek concept, the humorist. In this concept, all human organs have a health temperament that has four essential qualities such as coldness, hotness, wetness and dryness. When the equilibrium state of these qualities is disturbed, the organs transform to unhealthy temperament which was traditionally referred to as “intemperament.” For example, if the temperament of the brain is exposed to coldness, cold intemperament in the brain will happen. By this concept, ancient Iranian medicine categorizes dementia into four groups: cold and wet, simple cold, hot and dry and cold and dry. This paper focuses on how therapy can be provided in the case of a seventy-six old man diagnosed with Alzheimer’s disorder.
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 Case Management-Nurse Advocate

Case Management:Nurse Advocate

Ethics, moral, and legal standards guide the conduct of a nurse throughout his or her profession. Ethics determine the principles that govern a nurse behavior while executing respective duties and responsibilities. The ability to determine right or wrong states his or her moral position. Some rules and regulations governing the conduct of nursing which each nurse ought to follow. A prudent nurse adheres to the nursing ethical, moral, and legal standards as well as a code of conduct (McKee et al., 2014). During execution of duties and responsibilities, a nurse encounters several issues that encompass ethics, moral, or legal standards.

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The behavior of a nursing officer in solving such scenarios depicts the level of his level of leadership competence or experience. This paper evaluates a moral issue I encountered in my workplace, analyzes the moral, ethical, and legal implications applied while attempting to solve the situation, describes my role as an advocate for the issue, and evaluates my leadership styles.

Moral Issue Encountered in Work Environment
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Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder

Many types of research concerning the illness that affect the human have been done to help improve the living standard and eliminate worries that may be brought through abnormality in most of the organs of the body. The brain as one of the organs is associated with may illnesses. ADHD is one of the considered as a highly generic and brain-based syndrome, which is linked to the regulation of a particular set of the functions of the brain and related behaviors (Bird, 2017). According to Wolraich (2016), most of the cases of the people diagnosed with the disorder are found within the age bracket of 6 to 12 years. Therefore, the disorder has been linked to children inattentiveness, hyperactivity, and impulsiveness, which make them perform dismally when at school. Although the research by American Psychiatric Association indicates that many children experience the phases of restlessness or inattentiveness, they should not be linked to having suffered the ADHD (Wolraich, 2016).

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The teacher’s recommendation on the behavior of the child at school helps in guiding the way forward in seeking the medical attention through testing the behavior of the child. In connection with this disorder, this paper is going to address the case study of a naughty girl who is at the age of 8. It provides the decisions on the treatment process concerning the illness (ADHD, the inattentive type with comorbid ODD) the girl was diagnosed with and aims to help her regain her normal status. Though the study shows a combination of therapy and medication would help treat the illness, this paper is going to focus only on the medication treatment.

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Psychiatric nursing Case Study

Psychiatric nursing Case Study

Case Study

List of questions to the patient
· What medical conditions do you have or might have been diagnosed?
· Do you have medical conditions such as high blood pressure or diabetes?
· Did you had any childhood illness such as measles or chicken pox?
· Does any member of your family have similar conditions of depression?
· Are you currently on any kind of medication?

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· If yes, what is the name of the medications that you are currently undertaking?
· Have you ever been treated for depression in the past?
· Do you take or have you taken in the past any kind of illicit drugs? Other people in the patient’s life to get the feedback
· The parents
These are the family member that gives good details concerning the childhood history of the patient concerning various illness.
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Ethical Frameworks for Advanced Nursing Practice of Psychiatric Care

Ethical Frameworks for Advanced Nursing Practice of Psychiatric Care

Phenomenon of interest

The selected phenomenon of interest (POI) is managing anxiety among adults. The excessive anxiety that leads to distress or interferes with the daily activities is not part of normal aging and can lead to decreased functioning in everyday life and a variety of health problems. The most common anxiety disorders include panic disorder, obsessive-compulsive disorder, social phobia, and post-traumatic stress disorder (PTSD). In older adults, anxiety may be linked to several important risk factors including stressful life events, chronic medical conditions, stressful life events, sleep disturbance, negative or difficult events in childhood and overall feelings of poor health. Individuals with anxiety disorders experience poor physical health outcomes such reduced average life expectancy of 25 years or less as opposed to the rest of the population.

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One of the major barriers to accessing mental healthcare services among this population is social stigma. Healthy equity involves the provision of equal opportunity for all people to benefit from optimal health. The World Health Organization and the U.S government provide support in promoting mental health while recognizing the possible barriers which prelude healthy equity. The Healthy People 2020 incorporated the elements of social determinants during its launch of four overarching goals. One of the overarching goals is to improve the health of all groups, eliminate disparities and achieve equity in accessing health care services (Satcher & Rachel, 2017).
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